1978
DOI: 10.1001/jama.1978.03280280031019
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Peritoneovenous (LeVeen) Shunt

Abstract: Because of the unusual clinical course of a patient with hepatic cirrhosis, refractory ascites, and hepatorenal syndrome, we were able to examine the complex interrelationships between massive ascites, renin-aldosterone activity, and renal and hepatic function before and after placement of a peritoneojugular vein (LeVeen) shunt. Measurements indicated that when the shunt was functioning, renin-aldosterone production was suppressed, the hepatorenal syndrome was reversed, and ascites remitted. These data suggest… Show more

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Cited by 27 publications
(3 citation statements)
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“…Similar results may be obtained by portocaval shunt ing in man with cirrhosis [37][38][39][40][41][42]. Based on all the observations above, it is tempting to suggest that the extreme prerenal pattern of the HRS is the consequence of the 'underfill ing' of the circulation in cirrhosis.…”
Section: Pathophysiologysupporting
confidence: 64%
See 1 more Smart Citation
“…Similar results may be obtained by portocaval shunt ing in man with cirrhosis [37][38][39][40][41][42]. Based on all the observations above, it is tempting to suggest that the extreme prerenal pattern of the HRS is the consequence of the 'underfill ing' of the circulation in cirrhosis.…”
Section: Pathophysiologysupporting
confidence: 64%
“…Over the last decade, the use of the peritoneo-jugular LeVeen shunt received much attention [37][38][39][40][41][42], The reduction in intra abdominal pressure combined with increased central blood volume caused by the shunt ('artificial thoracic duct') in some patients led to an improvement in their hemodynamic status, restoration of renal perfusion, GFR and increase in urine output and sodium excretion. However, the procedure is associ ated with relatively high risk and morbidity including infections, coagulopathies and var ious technical problems [70], At present, the LeVeen shunt cannot yet be regarded as an established terapy for HRS patients [70,71].…”
Section: Therapy Of the Hrsmentioning
confidence: 99%
“…The peritoneovenous LeVeen shunt (PVLS) is a device that has proved effective in treating refractory massive ascites (1)(2)(3). Bacterial infection is a main complication of the PVLS, occurring in 15-55% of the patients, and is responsible for 50% of the early deaths after its insertion (4)(5).…”
mentioning
confidence: 99%